PN 140 test # 4 (nclex) qui Terms in this set (120) A patient is diagnosed with an infection caused by the hepatitis A virus. Which statement, if made by the patient, would indicate the patient needs further teaching about the infection? A "I

PN 140 test # 4 (nclex) qui Terms in this set (120) A patient is diagnosed with an infection caused by the hepatitis A virus. Which statement, if made by the patient, would indicate the patient needs further teaching about the infection? A "I will wash raw fruits and vegetables thoroughly before I eat them." B "Before I take any over-the-counter medicines I should call the clinic." C "I might get liver cancer someday because I have this infection." D "It's important for me to remember to wash my hands after I use the bathroom." C "I might get liver cancer someday because I have this infection." A member of the clinic housekeeping staff experiences a needlestick by a contaminated needle. Which of the following should be administered by the healthcare provider to provide the patient with passive immunity against the hepatitis B virus? A Antiviral medication B Hepatitis B immune globulin (HBIG) C Hepatitis B vaccine D Interferon B Hepatitis B immune globulin (HBIG) A patient is admitted to the medical unit with a diagnosis of hepatitis. When preparing to administer intravenous medications, the healthcare provider understands that the patient's diagnosis primarily impacts which phase of pharmacokinetics? A Absorption B Distribution C Metabolism D Excretion C Metabolism Assessment findings for a patient diagnosed with alcoholic hepatitis and portal hypertension include oliguria and increasing blood urea nitrogen (BUN). Which additional assessment finding would be consistent with a diagnosis of hepatorenal syndrom A Increased urine sodium B Increased serum creatinin C Flank pain and proteinuria D B Increased serum creatinin PN 140 test # 4 (nclex) A patient diagnosed with viral hepatitis is prescribed ribavirin and interferon alfa-2a. The patient calls the clinic to report shortness of breath and increasing fatigue over the past week. Which of the following responses would be most appropriate for the healthcare provider to make? A "Do you have any other symptoms such as a headache or rash?" B "Please come to the clinic so we can send some of your blood to the lab' C "How many hours of sleep do you usually get each night?" D "These symptoms are very common in patients diagnosed with hepatitis.' A "Do you have any other symptoms such as a headache or rash?" When caring for a patient diagnosed with viral hepatitis, the healthcare provider experiences a needlestick with a contaminated needle. Which of the following actions should the healthcare provider do first? A Make an appointment with the infection control department B Put the needle in a biohazard bag for testing C Wash the area thoroughly with soap and water D Report to the emergency department C Wash the area thoroughly with soap and water A patient diagnosed with viral hepatitis develops liver failure and hepatic encephalopathy. Which of these measures should the healthcare provider include in this patient's plan of care? Select all that apply: A Assess deep tendon reflexes B Monitor the patient's blood glucose C Monitor the patient's protime (PT) D Institute droplet precautions E Provide high-protein feedings A,B,C A patient diagnosed with chronic hepatitis is admitted to the medical unit with ascites. Which of the following mechanisms will the healthcare provider identify as contributing to the development of ascites in this patient? Select all that apply: A Increased serum aldosterone B Increased liver fibrosis C Decreased production of vitamin K D Decreased venous hydrostatic pressure E Decreased serum albumin A,B,E The healthcare provider is teaching a patient diagnosed with hepatitis C about the disease. Which of these statements made by the patient indicate that the patient has an understanding of the teaching? Select all that apply: A "I should get vaccinated for hepatitis A and hepatitis B." B "It's important for me to use barrier protection when I have sex." C "I should not drink any wine, beer or other alcoholic beverages." D "I'll plan to do all my activities in the morning when I'm most rested." E "I should avoid sharing drinking cups and eating utensils with my family." F "Acetaminophen is the best medication for me if I have a headache." A,B,C A patient diagnosed with hepatitis is undergoing a liver biopsy. When caring for the patient, which of these actions would be essential for the healthcare provider to take? Select all that apply: A Review the patient's baseline liver function tests B Ensure the patient's clotting profile is within normal limits C Provide a mechanical soft diet for before the procedure D Ensure the patient has an empty bladder before the procedure E Help the patient assume a left lateral position after the procedure F Monitor the patient's vital signs after the procedure B,D,F A patient diagnosed with chronic hepatitis has developed hepatic encephalopathy. When assessing the patient, the healthcare provider looks for which of the following clinical manifestations characteristic of this condition Select all that apply: A Retroperitoneal bleeding B Involuntary hand tremor C Bloody emesis D Shortened attention span E Hypersomnia F Slurred speech B,D,E,F A pt is admitted to the hospital with viral hepatitis, complaining of "no appetite" and "losing my taste for food." What instruction should the nurse give the client to provide adequate nutrition? A Select foods high in fat. B Increase intake of fluids, including juice. C Eat a food supper when anorexia is not as severe. D Eat less often, preferably only three large meals. B Increase intake of fluids, including juice. A pt has developed hepatitis A after eating contaminated oysters. The nurse assesses the pt for which expected assessment finding? A Malaise B Dark Stools C Weight gain D Left upper quadrant discomfort A Malaise The health care provider has determined that a client with hepatitis has contracted the infection from contaminated food. The nurse understands that this client is most likely experiencing what type of hepatitis? A Hepatitis A B Hepatitis B C Hepatitis C D Hepatitis D A Hepatitis A A patient with hep A is in the acute phase. The nurse plans care for the pt based on the knowledge that: A pruritus is a common problem with jaundice in this phase. B the pt is most likely to transmit the disease during this phase C GI symptoms are not as severe in hep A as they are in hep B D extrahepatic manifestations of glomerulonephritis and polyarteritis are common in this phase A pruritus is a common problem with jaundice in this phase. PN 140 test # 4 (nclex) A patient who has tested positive for the human immunodeficiency virus (HIV) arrives at the clinic with a report of fever, nonproductive cough, and fatigue. The patient's CD4 count is 184 cells/mcL. How should the healthcare provider interpret these findings? A These findings provide evidence that the patient has seroconverted. B The patient is now in the latent stages of HIV infection. C The patient is diagnosed with AIDS. D This is an expected finding because the patient has tested positive for HIV. C The patient is diagnosed with AIDS. The healthcare provider is teaching a patient who has been diagnosed with acquired immunodeficiency syndrome (AIDS) about the need for multi-drug therapy. Which of the following best explains the rationale for using more than one antiretroviral medication to treat AIDS? A "This is intended to keep the virus from developing resistance to the medications." B "You will experience less side effects when you take a combination of medications." C "You will not be able to transmit the disease while you take this medication combination." D "This combination of medications will eliminate the AIDS virus from your body." A "This is intended to keep the virus from developing resistance to the medications." The healthcare provider is assessing the skin of a patient who is at risk for becoming infected with the human immunodeficiency virus (HIV). Which of the following findings requires immediate follow-up by the healthcare provider? A Purplish-red raised lesions B Numerous moles on the chest and back C Ecchymoses on the legs D Patches of dry, flaky skin A Purplish-red raised lesions The healthcare provider is teaching a student about the disease process of HIV. Which of the following information should the healthcare provider include? A HIV RNA is inserted into the host cell mitochondria B The HIV virus divides quickly inside red blood cells C HIV begins to phagocytize host immune cells D HIV RNA is transcribed into DNA D HIV RNA is transcribed into DNA A patient who has been diagnosed with acquired immunodeficiency syndrome (AIDS) has been prescribed a combination of the medications lopinavir and ritonavir. The patient asks why these two medications are given together. What is the best response by the healthcare provider? A "Ritonavir helps increase the effectiveness of lopinavir." B "This is a way of giving a lower dose of each of the medications." C "Ritonavir helps decrease potential adverse effects of lopinavir." D "By combining two medications together you won't have to take as many pills." A "Ritonavir helps increase the effectiveness of lopinavir." A patient who has been diagnosed with acquired immunodeficiency syndrome (AIDS) develops an oral Candida infection. When teaching the patient, the healthcare provider will include which of the following instructions? A "Include plenty of citrus juices in your diet." B "Select foods that are soft or pureed." C "Include hot soups and beverages with each meal." D "Rinse your mouth often with a commercial mouthwash." B "Select foods that are soft or pureed." The healthcare provider is teaching a patient who has a diagnosis of acquired immunodeficiency syndrome (AIDS) about food safety. Which of the following foods should the patient avoid to prevent foodborne illnesses? A Green salad B Mozzarella cheese C Deli meats D Boiled eggs C Deli meats A patient who has been receiving antiretroviral therapy (ART) to manage infection with human immunodeficiency virus (HIV) has an undetectable viral load. How would the healthcare provider interpret this information? A HIV has been eliminated from the patient's blood. B ART has been effective in decreasing viral load. C More tests are needed to determine the effectiveness of ART. D ART can be discontinued for three months. B ART has been effective in decreasing viral load. 1 is solely filtered from the bloodstream via the glomerulus and is NOT reabsorbed back into the bloodstream but is excreted through the urine.* A. Urea B. Creatinine C. Potassium D. Magnesium B. Creatinine PN 140 test # 4 (nclex) A 55 year old male patient is admitted with a massive GI bleed. The patient is at risk for what type of acute kidney injury?* A. Post-renal B. Intra-renal C. Pre-renal D. Intrinsic renal C. Pre-renal The nurse is instructing an unlicensed health care worker on the care of the client with HIV who also has active genital herpes. Which statement by the health care worker indicates effective teaching of standard precautions? A) ''I need to know my HIV status, so I must get tested before caring for any clients." B) ''Putting on a gown and gloves will cover up the itchy sores on my elbows.'' C) ''Washing my hands and putting on a gown and gloves is what I must do before starting care.'' D) ''I will wash my hands before going into the room, and then put on gown and gloves only for direct contact with the client's genitals." C "Washing my hands and putting on a gown and gloves is what I must do before starting care." When preparing the newly diagnosed client with HIV and significant other for discharge, which explanation by the nurse accurately describes proper condom use? A) ''Condoms should be used when lesions on the penis are present.'' B) ''Always position the condom with a space at the tip of an erect penis.'' C) ''Make sure it fits loosely to allow for penile erection.'' D) ''Use adequate lubrication such as petroleum jelly.'' B "Always position the condom with a space at the tip of an erect penis." The nurse presents a seminar on HIV testing to a group of seniors and their caregivers in an assisted living facility. Which responses fit the Centers for Disease Control and Prevention's (CDC's) recommendations for HIV testing? (Select all that apply.) A) ''I am 78 years old and I was treated and cured of syphilis many years ago.'' B) ''In 1986, I received a transfusion of platelets.'' C) ''Seven years ago, I was released from a penitentiary.'' D) ''I used to smoke marijuana 30 years ago, but I have not done any drugs since.'' E) ''I had sex with a man with a disreputable past from New York back in the late 1960s, but I have been happily married since 1971.'' F) ''At 68, I am going to get married for the fourth time.'' A,C,F The nurse is caring for a patient newly diagnosed with HIV. The patient asks what would determine the actual development of AIDS. The nurse's response is based on the knowledge that what is a diagnostic criterion for AIDS? A. Presence of HIV antibodies B. CD4 T cell count below 200 C. Presence of oral hairy leukoplakia D. White blood cell count below 5000/µl B. CD4 T cell count below 200 When teaching a patient infected with HIV regarding transmission of the virus to others, which statement made by the patient would indicate a need for further teaching? A. "I will need to isolate any tissues I use so as not to infect my family." B. "I will notify all of my sexual partners so they can get tested for HIV." C. "Unprotected sexual contact is the most common mode of transmission." D. "I do not need to worry about spreading this virus to others by sweating at the gym." A. "I will need to isolate any tissues I use so as not to infect my family." The nurse is providing care for a patient who has been living with HIV for several years. Which assessment finding most clearly indicates an acute exacerbation of the disease? A. A new onset of polycythemia B. Presence of mononucleosis-like symptoms C. A sharp decrease in the patient's CD4 count D. A sudden increase in the patient's WBC count C. A sharp decrease in the patient's CD4 count The woman is afraid she may get HIV from her bisexual husband. What should the nurse include when teaching her about preexposure prophylaxis (select all that apply)? A. Take fluconazole (Diflucan). B. Take amphotericin B (Fungizone). C. Use condoms for risk-reducing sexual relations. D. Take emtricitabine and tenofovir (Truvada) regularly. E. Have regular HIV testing for herself and her husband. C,D,E The nurse was accidently stuck with a needle used on an HIV-positive patient. After reporting this, what care should this nurse first receive? A. Personal protective equipment B. Combination antiretroviral therapy C. Counseling to report blood exposures D. A negative evaluation by the manager B. Combination antiretroviral therapy A 52-year-old female patient was exposed to human immunodeficiency virus (HIV) two weeks ago through sharing needles with other substance users. What symptoms will the nurse teach the patient to report that would indicate the patient has developed an acute HIV infection? A Cough, diarrhea, headaches, blurred vision, muscle fatigue B Night sweats, fatigue, fever, and persistent generalized lymphadenopathy C Oropharyngeal candidiasis or thrush, vaginal candidal infection, or oral or genital herpes D Flu-like symptoms such as fever, sore throat, swollen lymph glands, nausea, or diarrhea D Flu-like symptoms such as fever, sore throat, swollen lymph glands, nausea, or diarrhea Which priority teaching information should the nurse discuss with the client to help prevent contracting Hep. B? A Explain the importance of good hand washing. B Tell the client to take the hepatitis B vaccine in three (3) doses. C Tell the client not to ingest unsanitary food or water. D Discuss how to implement standard precautions. A Explain the importance of good hand washing. A client is suspected of having hepatitis. Which diagnostic test result will assist in confirming this diagnosis ? A Elevated hemoglobin level B Elevated serum bilirubin level C Elevated blood urea nitrogen level D Decreased erthyrocyte sedimentation B Elevated serum bilirubin level The patient in the clinic has recently been diagnosed with viral hepatitis. The nurse anticipates that which test will be used to predict the virus's response to therapy? A Genotype assay B Molecular assay C Western blot test D Enzyme immunoassay A Genotype assay Which statement(s) is/are most accurate regarding transmission of human immunodeficiency virus (HIV) and development of acquired immune deficiency syndrome (AIDS)? Select all that apply. A It is treatable. B Poor personal hygiene is a factor in its transmission. C It cannot be transmitted if safer sexual practices are used. D It enters the bloodstream through breaks in mucous membrane. E It is a blood-borne pathogen and can be transmitted by contaminated intravenous (IV) drug use supplies. A,D,E A patient with CKD has a low erythropoietin (EPO) level. The patient is at risk for?* A. Hypercalcemia B. Anemia C. Blood clots D. Hyperkalemia B. Anemia A 65 year old male patient has a glomerular filtration rate of 55 mL/min. The patient has a history of uncontrolled hypertension and coronary artery disease. You're assessing the new medication orders received for this patient. Which medication ordered by the physician will help treat the patient's hypertension along with providing a protective mechanism to the kidneys?* A. Lisinopril B. Metoprolol C. Amlodipine D. Verapamil A. Lisinopril Which patient below is NOT at risk for developing chronic kidney disease?* A. A 58 year old female with uncontrolled hypertension. B. A 69 year old male with diabetes mellitus. C. A 45 year old female with polycystic ovarian disease. D. A 78 year old female with an intrarenal injury. C. A 45 year old female with polycystic ovarian disease. A patient with Stage 5 CKD is experiencing extreme pruritus and has several areas of crystallized white deposits on the skin. As the nurse, you know this is due to excessive amounts of what substance found in the blood?* A. Calcium B. Urea C. Phosphate B. Urea PN 140 test # 4 (nclex) While assessing morning labs on your patient with CKD. You note the patient's phosphate level is 6.2 mg/dL. As the nurse, you expect to find the calcium level to be?* A. Elevated B. Low C. Normal D. Same as the phosphate level B. Low A patient with stage 4 chronic kidney disease asks what type of diet they should follow. You explain the patient should follow a:* A. Low protein, low sodium, low potassium, low phosphate diet B. High protein, low sodium, low potassium, high phosphate diet C. Low protein, high sodium, high potassium, high phosphate diet D. Low protein, low sodium, low potassium, high phosphate diet A. Low protein, low sodium, low potassium, low phosphate diet A patient with acute renal injury has a GFR (glomerular filtration rate) of 40 mL/min. Which signs and symptoms below may this patient present with? Select all that apply:* A. Hypervolemia B. Hypokalemia C. Increased BUN level D. Decreased Creatinine level A,C Select all the patients below that are at risk for acute intra-renal injury?* A. A 45 year old male with a renal calculus. B. A 65 year old male with benign prostatic hyperplasia. C. A 25 year old female receiving chemotherapy. D. A 36 year old female with renal artery stenosis. E. A 6 year old male with acute glomerulonephritis. F. An 87 year old male who is taking an aminoglycoside medication for an infection. C,E,F A 36 year old male patient is diagnosed with acute kidney injury. The patient is voiding 4 L/day of urine. What complication can arise based on the stage of AKI this patient is in? Select all that apply:* A. Water intoxication B. Hypotension C. Low urine specific gravity D. Hypokalemia E. Normal GFR B,C,D Which patient below with acute kidney injury is in the oliguric stage of AKI:* A. A 56 year old male who has metabolic acidosis, decreased GFR, increased BUN/Creatinine, hyperkalemia, edema, and urinary output 350 mL/day. B. A 45 year old female with metabolic alkalosis, hypokalemia, normal GFR, increased BUN/creatinine, edema, and urinary output 600 mL/day. C. A 39 year old male with metabolic acidosis, hyperkalemia, improving GFR, resolving edema, and urinary output 4 L/day. D. A 78 year old female with respiratory acidosis, increased GFR, decreased BUN/creatinine, hypokalemia, and urinary output 550 mL/day. A. A 56 year old male who has metabolic acidosis, decreased GFR, increased BUN/Creatinine, hyperkalemia, edema, and urinary output 350 mL/day. You're developing a nursing care plan for a patient in the diuresis stage of AKI. What nursing diagnosis would you include in the care plan?* A. Excess fluid volume B. Risk for electrolyte imbalance C. Urinary retention D. Acute pain B. Risk for electrolyte imbalance Presence of which of the following in the urine, even in small amounts, is indicative of a possible problem in the renal system of a patient? A Glucose B Creatinine C Urea D Sodium A Glucose You have a patient that is receiving peritoneal dialysis. What should you do when you notice the return fluid is slowly draining? A Check for kinks in the outflow tubing B Raise the drainage bag above the level of the abdomen C Place the patient in a reverse Trendelenburg position D Ask the patient to cough A Check for kinks in the outflow tubing What is the appropriate infusion time for the dialysate in your 38 y.o. patient with chronic renal failure? A 15 minutes B 30 minutes C 1 hour D 2 to 3 hours A 15 minutes A 30 y.o. female patient is undergoing hemodialysis with an internal arteriovenous fistula in place. What do you do to prevent complications associated with this device? A Insert I.V. lines above the fistula. B Avoid taking blood pressures in the arm with the fistula C Palpate pulses above the fistula D Report a bruit or thrill over the fistula to the doctor B Avoid taking blood pressures in the arm with the fistula Your patient becomes restless and tells you she has a headache and feels nauseous during hemodialysis. Which complication do you suspect? A Infection B Disequilibrium syndrome C Air embolus D Acute hemolysis B Disequilibrium syndrome Your patient is complaining of muscle cramps while undergoing hemodialysis. Which intervention is effective in relieving muscle cramps? A Increase the rate of dialysis B Infuse normal saline solution C Administer a 5% dextrose solution D Encourage active ROM exercises B Infuse normal saline solution Your patient with chronic renal failure reports pruritus. Which instruction should you include in this patient's teaching plan? A Rub the skin vigorously with a towel B Take frequent baths C Apply alcohol-based emollients to the skin D Keep fingernails short and clean D Keep fingernails short and clean Which intervention do you plan to include with a patient who has renal calculi? A Maintain bed rest B Increase dietary purines C Restrict fluids D Strain all urine D Strain all urine Which drug is indicated for pain related to acute renal calculi? A Narcotic analgesics B Nonsteroidal anti-inflammatory drugs (NSAIDS) C Muscle relaxants D Salicylates A Narcotic analgesics You expect a patient in the oliguric phase of renal failure to have a 24 hour urine output less than: A 200ml B 400ml C 800ml D 1000ml B 400ml The most common early sign of kidney disease is: A Sodium retention B Elevated BUN level C Development of metabolic acidosis D Inability to dilute or concentrate urine B Elevated BUN level Immediately post-op after a prostatectomy, which complications requires priority assessment of your patient? A Pneumonia B Hemorrhage C Urine retention D Deep vein thrombosis B Hemorrhage What is the priority nursing diagnosis with your patient diagnosed with end-stage renal disease? A Activity intolerance B Fluid volume excess C Knowledge deficit D Pain B Fluid volume excess A patient with ESRD has an arteriovenous fistula in the left arm for hemodialysis. Which intervention do you include in his plan of care? A Apply pressure to the needle site upon discontinuing hemodialysis B Keep the head of the bed elevated 45 degrees C Place the left arm on an arm board for at least 30 minutes D Keep the left arm dry A Apply pressure to the needle site upon discontinuing hemodialysis Which sign indicated the second phase of acute renal failure? A Daily doubling of urine output (4 to 5 L/day) B Urine output less than 400 ml/day C Urine output less than 100 ml/day D Stabilization of renal function A Daily doubling of urine output (4 to 5 L/day) Your patient had surgery to form an arteriovenous fistula for hemodialysis. Which information is important for providing care for the patient? A The patient shouldn't feel pain during initiation of dialysis B The patient feels best immediately after the dialysis treatment C Using a stethoscope for auscultating the fistula is contraindicated D Taking a blood pressure reading on the affected arm can cause clotting of the fistula D Taking a blood pressure reading on the affected arm can cause clotting of the fistula A patient with diabetes mellitus and renal failure begins hemodialysis. Which diet is best on days between dialysis treatments? A Low-protein diet with unlimited amounts of water B Low-protein diet with a prescribed amount of water C No protein in the diet and use of a salt substitute D No restrictions B Low-protein diet with a prescribed amount of water After the first hemodialysis treatment, your patient develops a headache, hypertension, restlessness, mental confusion, nausea, and vomiting. Which condition is indicated? A Disequilibrium syndrome B Respiratory distress C Hypervolemia D Peritonitis A Disequilibrium syndrome A patient with diabetes has had many renal calculi over the past 20 years and now has chronic renal failure. Which substance must be reduced in this patient's diet? A Carbohydrates B Fats C Protein D Vitamin C C Protein What is the best way to check for patency of the arteriovenous fistula for hemodialysis? A Pinch the fistula and note the speed of filling on release B Use a needle and syringe to aspirate blood from the fistula C Check for capillary refill of the nail beds on that extremity D Palpate the fistula throughout its length to assess for a thrill D Palpate the fistula throughout its length to assess for a thrill You have a paraplegic patient with renal calculi. Which factor contributes to the development of calculi? A Increased calcium loss from the bones B Decreased kidney function C Decreased calcium intake D High fluid intake A Increased calcium loss from the bones What is the most important nursing diagnosis for a patient in end-stage renal disease? A Risk for injury B Fluid volume excess C Altered nutrition: less than body requirements D Activity intolerance B Fluid volume excess PN 140 test # 4 (nclex) You're developing a care plan with the nursing diagnosis risk for infection for your patient that received a kidney transplant. A goal for this patient is to: A Remain afebrile and have negative cultures B Resume normal fluid intake within 2 to 3 days C Resume the patient's normal job within 2 to 3 weeks D Try to discontinue cyclosporine (Neoral) as quickly as possible A Remain afebrile and have negative cultures You suspect kidney transplant rejection when the patient shows which symptoms? A Pain in the incision, general malaise, and hypotension B Pain in the incision, general malaise, and depression C Fever, weight gain, and diminished urine output D Diminished urine output and hypotension C Fever, weight gain, and diminished urine output Which cause of hypertension is the most common in acute renal failure? A Pulmonary edema B Hypervolemia C Hypovolemia D Anemia B Hypervolemia Which statement correctly distinguishes renal failure from prerenal failure? A With prerenal failure, vasoactive substances such as dopamine (Intropin) increase blood pressure B With prerenal failure, there is less response to such diuretics as furosemide (Lasix) C With prerenal failure, an IV isotonic saline infusion increases urine output D With prerenal failure, hemodialysis reduces C With prerenal failure, an IV isotonic saline infusion increases urine output PN 140 test # 4 (nclex) Which criterion is required before a patient can be considered for continuous peritoneal dialysis? A The patient must be hemodynamically stable B The vascular access must have healed C The patient must be in a home setting D Hemodialysis must have failed A The patient must be hemodynamically stable Your patient has complaints of severe right- sided flank pain, nausea, vomiting and restlessness. He appears slightly pale and is diaphoretic. Vital signs are BP 140/90 mmHg, Pulse 118 beats/min., respirations 33 breaths/minute, and temperature, 98.0F. Which subjective data supports a diagnosis of renal calculi? A Pain radiating to the right upper quadrant B History of mild flu symptoms last week C Dark-colored coffee-ground emesis D Dark, scanty urine output D Dark, scanty urine output A client had a transurethral prostatectomy for benign prostatic hypertrophy. He's currently being treated with a continuous bladder irrigation and is complaining of an increase in severity of bladder spasms. Which of the interventions should be done first? A Administer an oral analgesic B Stop the irrigation and call the physician C Administer a belladonna and opium suppository as ordered by the physician D Check for the presence of clots, and make sure the catheter is draining properly D Check for the presence of clots, and make sure the catheter is draining properly PN 140 test # 4 (nclex) A client has passed a renal calculus. The nurse sends the specimen to the laboratory so it can be analyzed for which of the following factors? A Antibodies B Type of infection C Composition of calculus D Size and number of calculi C Composition of calculus When providing discharge teaching for a client with uric acid calculi, the nurse should an instruction to avoid which type of diet? A Low-calcium B Low-oxalate C High-oxalate D High-purine D High-purine The nurse is receiving in transfer from the postanesthesia care unit a client who has had a percutaneous ultrasonic lithotripsy for calculuses in the renal pelvis. The nurse anticipates that the client's care will involve monitoring which of the following? A Suprapubic tube B Urethral stent C Nephrostomy tube D Jackson-Pratt drain C Nephrostomy tube The nurse is taking the history of a client who has had benign prostatic hyperplasia in the past. To determine whether the client currently is experiencing difficulty, the nurse asks the client about the presence of which of the following early symptoms? A Urge incontinence B Nocturia C Decreased force in the stream of urine D Urinary retention C Decreased force in the stream of urine PN 140 test # 4 (nclex) The client who has a cold is seen in the emergency room with inability to void. Because the client has a history of BPH, the nurse determines that the client should be questioned about the use of which of the following medications? A Diuretics B Antibiotics C Antitussives D Decongestants D Decongestants The client passes a urinary stone, and lab analysis of the stone indicates that it is composed of calcium oxalate. Based on this analysis, which of the following would the nurse specifically include in the dietary instructions? A Increase intake of meat, fish, plums, and cranberries B Avoid citrus fruits and citrus juices C Avoid green, leafy vegetables such as spinach D Increase intake of dairy products C Avoid green, leafy vegetables such as spinach The client with BPH undergoes a transurethral resection of the prostate. Postoperatively, the client is receiving continuous bladder irrigations. The nurse assesses the client for signs of transurethral resection syndrome. Which of the following assessment data would indicate the onset of this syndrome? A Bradycardia and confusion B Tachycardia and diarrhea C Decreased urinary output and bladder spasms D Increased urinary output and anemia A Bradycardia and confusion The client is admitted to the hospital with BPH, and a transurethral resection of the prostate is performed. Four hours after surgery the nurse takes the client's VS and empties the urinary drainage bag. Which of the following assessment findings would indicate the need to notify the physician? A Red bloody urine B Urinary output of 200 ml greater than intake C Blood pressure of 100/50 and pulse 130 D Pain related to bladder spasms C Blood pressure of 100/50 and pulse 130 A client who has been diagnosed with calculi reports that the pain is intermittent and less colicky. Which of the following nursing actions is most important at this time? A Report hematuria to the physician B Strain the urine carefully C Administer meperidine (Demerol) every 3 hours D Apply warm compresses to the flank area B Strain the urine carefully Because a client's renal stone was found to be composed to uric acid, a low-purine, alkaline-ash diet was ordered. Incorporation of which of the following food items into the home diet would indicate that the client understands the necessary diet modifications? A Milk, apples, tomatoes, and corn B Eggs, spinach, dried peas, and gravy C Salmon, chicken, caviar, and asparagus D Grapes, corn, cereals, and liver A Milk, apples, tomatoes, and corn A 72-year old male client is brought to the emergency room by his son. The client is extremely uncomfortable and has been unable to void for the past 12 hours. He has known for some time that he has an enlarged prostate but has wanted to avoid surgery. The best method for the nurse to use when assessing for bladder distention in a male client is to check for: A A rounded swelling above the pubis. B Dullness in the lower left quadrant C Rebound tenderness below the symphysis D Urine discharge from the urethral meatus A A rounded swelling above the pubis. The primary function of the prostate gland is: A To store underdeveloped sperm before ejaculation B To regulate the acidity and alkalinity of the environment for proper sperm development. C To produce a secretion that aids in the nourishment and passage of sperm D To secrete a hormone that stimulates the production and maturation of sperm C To produce a secretion that aids in the nourishment and passage of sperm The nurse is reviewing a medication history of a client with BPH. Which medication should be recognized as likely to aggravate BPH? A Metformin (Glucophage) B Buspirone (BuSpar) C Inhaled ipratropium (Atrovent) D Ophthalmic timolol (Timoptic) C Inhaled ipratropium (Atrovent) A client is scheduled to undergo a transurethral resection of the prostate gland (TURP). The procedure is to be done under spinal anesthesia. Postoperatively, the nurse should be particularly alert for early signs of: A Convulsions B Cardiac arrest C Renal shutdown D Respiratory paralysis D Respiratory paralysis A client with BPH is being treated with terazosin (Hytrin) 2 mg at bedtime. The nurse should monitor the client's: A Urinary nitrites B White blood cell count C Blood pressure D Pulse C Blood pressure A client underwent a TURP, and a large three way catheter was inserted in the bladder with continuous bladder irrigation. In which of the following circumstances would the nurse increase the flow rate of the continuous bladder irrigation? A When the drainage is continuous but slow B When the drainage appears cloudy and dark yellow C When the drainage becomes bright red D When there is no drainage of urine and irrigating solution C When the drainage becomes bright red A priority nursing diagnosis for the client who is being discharged to home 3 days after a TURP would be: A Deficient fluid volume B Imbalanced Nutrition: Less than Body Requirements C Impaired Tissue Integrity D A Deficient fluid volume PN 140 test # 4 (nclex) If a client's prostate enlargement is caused by a malignancy, which of the following blood examinations should the nurse anticipate to assess whether metastasis has occurred? A Serum creatinine level B Serum acid phosphatase level C Total nonprotein nitrogen level D Endogenous creatinine clearance time B Serum acid phosphatase level Dialysis allows for the exchange of particles across a semipermeable membrane by which of the following actions? A Osmosis and diffusion B Passage of fluid toward a solution with a lower solute concentration C Allowing the passage of blood cells and protein molecules through it D Passage of solute particles toward a solution with a higher concentration A Osmosis and diffusion A client is diagnosed with chronic renal failure and told she must start hemodialysis. Client teaching would include which of the following instructions? A Follow a high potassium diet B Strictly follow the hemodialysis schedule C There will be a few changes in your lifestyle D Use alcohol on the skin and clean it due to integumentary changes B Strictly follow the hemodialysis schedule PN 140 test # 4 (nclex) A client is undergoing peritoneal dialysis. The dialysate dwell time is completed, and the dwell clamp is opened to allow the dialysate to drain. The nurse notes that the drainage has stopped and only 500 ml has drained; the amount the dialysate instilled was 1,500 ml. Which of the following interventions would be done first? A Change the client's position B Call the physician C Check the catheter for kinks or obstruction D Clamp the catheter and instill more dialysate at the next exchange time C Check the catheter for kinks or obstruction A client receiving hemodialysis treatment arrives at the hospital with a blood pressure of 200/100, a heart rate of 110, and a respiratory rate of 36. Oxygen saturation on room air is 89%. He complains of shortness of breath, and +2 pedal edema is noted. His last hemodialysis treatment was yesterday. Which of the following interventions should be done first? A Administer oxygen B Elevate the foot of the bed C Restrict the client's fluids D Prepare the client for hemodialysis A Administer oxygen